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Lightning Round: Cleaning out my in box

2018 MIDTERM ELECTION

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Time: DHMS

Thu, 03/08/2018 - 8:57am

Every day I'm overwhelmed with so many important healthcare policy stories that I don't have time to do a full write-up on them all. Usually I just skip past most, but once in awhile I like to do quick posts on a bunch at a time.

Most people try to avoid reading their health insurance policies — that’s what employers and insurance agents are for. Anyone who plans to buy short-term health insurance, though, will need to read the policy carefully.

The Trump administration recently announced plans to allow consumers to buy short-term health insurance plans that last for up to a year. They are currently capped at 90 days.

Short-term health insurance used to be a niche product, primarily used by healthy people who wanted to have insurance between jobs or for other gaps in coverage. With an increase in the duration of these plans, a growing number of uninsured people might see them as an attractive — meaning less expensive — alternative to other forms of insurance, including plans that comply with the Affordable Care Act. Many won’t understand what they’re buying.

The number of Oneida County residents who signed up for insurance plans through the state’s insurance marketplace increased nearly 50 percent over the prior year’s open enrollment period, the most of any county in the state, according to county-level data released Tuesday.

Oneida County had 49,189 people select an insurance plan through New York State of Health, the state-based exchange set up after passage of the Affordable Care Act, up from 33,563 over the 2016-2017 open enrollment period.

That increase was overwhelmingly due to growth in Medicaid enrollment, which increased to 37,339 from 23,963. Medicaid made up more than 2.9 million of the over 4.3 million New Yorkers who enrolled through the exchange this year between Nov. 1 and Jan. 31.

Congress is running out of time if members want to come up with legislation to stabilize the individual insurance market.

While Republicans and Democrats still feud over the fate of the Affordable Care Act, a bipartisan group of senators and House members has been working since last summer on measures to keep prices from rising out of control and undermining the individual market where people who don’t get insurance through work or the government buy policies.

They hope to attach a package of fixes to what should be the year’s final temporary spending bill, due in late March.

The sun rises. The sun sets. Young people fall in love. Taxes are paid. People die. And Republicans make newer, dumber attempts to repeal Obamacare.

It’s an endless, unbreakable cycle of meritless lawsuits, half-baked legislation, and disingenuous political rhetoric. It would be hilarious if hundreds of thousands of lives weren’t at stake.

The latest effort to kill Obamacare is a lawsuit brought by 20 Republican governors and attorneys general alleging that, since Congress recently decided to deactivate a single provision of the law, the entire law must be taken down. It is a risible, insulting legal theory that several conservative legal observers have already described as incomprehensible and “too clever by half.”

To gauge the perspectives of Americans on the marketplaces, Medicaid, and other health insurance issues, the Commonwealth Fund Affordable Care Act Tracking Survey interviewed a random, nationally representative sample of 2,410 adults ages 19 to 64 between November 2 and December 27, 2017, including 541 people who have marketplace or Medicaid coverage. The findings are compared to prior ACA tracking surveys, the most recent of which was fielded between March and June 2017. The survey research firm SSRS conducted the survey, which has an overall margin of error is +/– 2.7 percentage points at the 95 percent confidence level. See How We Conducted This Study to learn more about the survey methods.

It is not often that a Governor sues his own citizens, but that’s what has happened in connection with Stewart v. Azar, a highly-watched case filed against the Trump administration that raises the question of whether the Department of Health and Human Services (HHS) Secretary has the power under federal law to approve Medicaid work demonstrations along with other major restrictions on Medicaid eligibility and coverage. In Bevin v. Stewart, filed February 9, Governor Matt Bevin of Kentucky mounted a legal case of his own against the Stewart plaintiffs. In this separate suit, Governor Bevin demands that Kentucky’s program be declared legal and that his separate case be heard in Kentucky. Along the way he uses the opportunity presented by his own case complaint to call out each individual Stewart plaintiff by name. Governor Bevin’s actions are troubling not because he has sued to have Kentucky’s program declared legal, but because this second lawsuit feels like little more than a pretext for going after the Stewart plaintiffs by name and in a public way, a retaliation of sorts for their effort to prevent what they believe to be the imminent loss of their Medicaid coverage.

The addition of work requirements and other sweeping changes to Kentucky’s Medicaid program could cost nearly $187 million in the first six months alone to get up and running.

Republican Gov. Matt Bevin projects that the program will eventually yield savings but the changes require an upfront investment in administrative expenses. Much of that money is aimed at creating complex electronic systems and other changes needed to track work hours, monthly premium payments and other elements of Kentucky’s recently approved plan to revamp the government insurance program for low-income Americans.

The vast majority of those dollars — more than $167 million — would be covered by the federal government, according to Bevin’s revised budget for fiscal 2018.